Are we getting complacent over Covid-19?

Note:  Over the past 6 months, I have published 2 reports based on the Google mobility reports - the first on 22 May and the other on 9 Jul 2020.  This post supersedes these 2 posts which have since been taken offline

Our PM has just announced that the RMCO would be extended till the end of the year because we continue to have Covid-19 cases.

The charts below illustrated what he said although when you dig deeper, almost half of the cases over the past 2 months came from imported cases.

Thus although the RMCO has been extended, we actually have got the virus under control. 

I did not watch the announcement and this was unlike the first few months of the MCO when I made it a point to watch all the PM announcement.

I suspect that it could be a case of COVID news fatigue.  

More worrisome is the idea that after 6 months, we have become numb to the danger of COVID-19

Malaysian Changing attitude

So have Malaysians attitudes and behavior towards Covid-19 changed? To get a sense of this, I look at several reports

• The Google Mobility report showing the relative movement

• The Google Trend report that shows the relative frequency people searched for particular keywords.  I took the frequency of search to be equivalent to the interest in the subject matter

• YouGov survey on Malaysian behavior over time

The general conclusions are

• Work and going to retail today has not returned to the pre-COVID-19 levels. 

• Malaysians are today less interested in the various keywords associated with COVID-19 eg coronavirus, face mask, movement control, quarantine, social distancing. The exceptions are

• COVID-19 vaccine where there is interest even today

• Hand washing where there was interest even before COVID-19

• Toilet paper that saw a spike in Mac. Haha

• Malaysians have maintained their views towards wearing face masks when in public and how well the government has handled Covid-19.  

The strange think is that less people ie 71% of Malaysians think that Covid-19 is getting better in the country down from 97 % in mid Jul.  This could be because we had 154 cases from 9 to 22 Jul compared to 212 cases from 6 to 19 Aug. 

Yes, there are signs of change and a certain level of disinterest.

Google mobility reports

If you look at the Google Mobility report, except for the workplace and retail, most of the other activities - visits to grocers/pharmacies, parks and residence are almost back to the pre-COVID-19 levels

• The workplace could be because there are those that are still working from home

• The retail could reflect that many are still not going out shopping like they used to

I suspect that since the RMCO is extended until the end of 2020, we will continue to see the workplace and retail effect till the end of the year. 

Notes from previous posts that have been discontinued

In the 9 July post, I did an analysis where I “synchronized” the time eg the virus situation in the second half of June has to be synchronized with what we did in the first half of June. 

This is to try to see the impact of the MCO on the movement of people. 

Not surprisingly, Malaysians responded very well to the measures.

You will notice that 

• When the MCO was implemented, there was an immediate impact on people going to work and staying at home.  Look at the sudden change in mobility. 

• But when the CMCO or even the RMCO was implemented, it took some time for the mobility to change.  Maybe people are still being cautious. 

But look at the impact on Covid-19

• MCO actually brought it down – this should not be any surprise

• The CMCO did not cause any surge even though people began to move about.   

• Note the spikes in early June was due to the detention centre clusters

• The RMCO has not caused any surge as well.  

For whatever is worth, our Covid-19 strategy has brought the virus under control without any 2nd wave. 

Google Trends

The trend report shows the relative frequency Malaysians searched for a particular phrase over time.

I looked at the following keywords commonly associated with Covid-19

• Coronavirus or COVID
• Face mask
• Movement control 
• Quarantine
• Social distancing
• Hand washing
• COVID vaccine

The chart shows the relative frequency for the various keywords for 3 period

• Before Covid-19

• At the height of COVID-19 in mid-Mac

• Currently in the 3rd week of Aug

Except for hand washing and the COVID vaccine, Malaysian have lost interest in the other Covid-19 related words. 

• As can be seen, hand washing has been searched even before Covid-19

• On the other hand, there is still interest in COVID vaccine currently

The charts below show how trends over the past 6 months for various keywords.

Note the spike in toilet paper in Mac.  Since then we all have lost interest. 

YouGov surveys

These are surveys conducted by YouGov in several countries to gauge the public’s opinion on a number of issues related to Covid-19.

I have picked up the results for Malaysia for the purpose of this post.

As can be seen 

• 71% of Malaysians think that Covid-19 is getting better in the country down from 97 % in mid-Jul.   Considering that we have 154 cases from 9 to 22 Jul compared to 212 cases from 6 to 19 Aug, we should not be surprised by this change in perception. 

• As far as wearing face masks is concerned, more people seem to agree with the idea today compared to one or two months ago

• Malaysians still believed that the government has done a good job

It is interesting to compare the current opinion with a cross-sectional online survey of 4,850 Malaysian residents conducted between 27th March and 3rd April 2020

“ …Most participants held positive attitudes toward the successful control of COVID-19, the ability of Malaysia to conquer the disease, and the way the Malaysian government was handling the crisis. Most participants were also taking precautions such as avoiding crowds and practicing proper hand hygiene in the week before the movement control order started. However, the wearing of face masks was less common..”   Public knowledge, attitudes, and practices towards COVID-19: A cross-sectional study in Malaysia.  PLoS One. 2020; 15(5): e0233668.

Possible reasons for the numbness

Getting “numb” or indifferent over Covid-19 after 6 months of hearing about it every day is not unexpected.

The experts have a word for this - information fatigue. 

Information fatigue is not something new. 

Information fatigue syndrome – also known as Information overload was coined by Georg Simmel, a social scientist who postulated that it can cause increasingly jaded and insensitive people incapable of logically reacting to situations.

Being distracted by information is not a modern phenomenon

• The Romans supposedly considered the abundance of books to be distracting

• The term “information overload” was used by Alvin Toffler in his book Future Shock in 1970

In the context of COVID-19, I came across several papers when researching for this post. 

1)  “…There is an "infodemic" in which false news, conspiracy theories, magical cures and racist news are being shared at an alarming rate, with the potential to increase anxiety and stress and even lead to loss of life.”  Information Overload and Infodemic in the COVID-19 Pandemic by Rathore, Farooq

2) .”..It is recommended that the public should cultivate the basic skills to evaluate information and determine its validity…. the authorities should refrain from placing the blame on patients to avoid them from being stigmatized…. all parties are aware of their ethical duty to ensure only ethical and valid information gets shared on social media.”  Sharing Information on COVID-19: the ethical challenges in the Malaysian setting.  Aimi Nadia Mohd Yusof, Muhamad Zaid Muuti, Lydia Aiseah Ariffin & Mark Kiak Min Tan

3)  Even our Star newspapers had an article in Mac on how to cope with the Covid-19 (mis)information overload.

Implications

Considering that Covid-19 will still be with us for a long time until a vaccine is widely available, we cannot afford to be “unconcerned” about what is happening.

• The first step to try to avoid the information overload

• Secondly, we have to be less complacent about Covid-19

Handling information overload

I found some advice from The Information Design Foundation which I thought was useful to help to tackle this problem.  Among others, they suggest that you

• Feel free to ignore the information.

• Learn to skim. Most information really only contains a key point or two – grab those points and move on.

• Filter information ruthlessly.

• Create an information queue and tackle it on a regular basis. Don’t feel pressured to deal with information as it arrives; put it to one side and tackle it in a quiet time of the day.

Complacency

“In countries seeing positive signs, the biggest threat now is complacency.” – WHO Director-General Tedros Adhanom Ghebreyesus

There have been several newspaper articles about the complacency creeping into Malaysia

• 18 Jul NST  Alliance for Safe Community chairman Tan Sri Lee Lam Thye said "… 'Covid-19 caution fatigue' has caught up with many Malaysians. Unless this is addressed it will create a sense of complacency, which will negate all good efforts we have achieved so far in tackling COVID 19.”

• Our PM in a televised speech on 20 Jul warned that another uncontrolled outbreak caused by public complacency would mean all the efforts by front-liners and the money poured in to revive the economy would have been gone to waste.

How can we tackle this?  I think it has to be a combination of govt efforts and our own efforts

Govt efforts

I quote a number of articles for you to decide whether this is valid.

• Sharon Lee, PharmD in CodeBlue opined that behavioral and mental health specialists are much needed to professionally assess this complacency and depression pattern that is creeping up the scale in the Malaysian population, and such assessment needs to happen soon in order to hit the brakes on this silent epidemic that is growing in the country. 

• "...Results indicate that the public showed signs of complacency under repeated emergency threat warnings and there is a need to manage or reduce such tendency …. Importantly, the study finds that the government plays a role in developing effective communication strategies to reduce public complacency and to enhance public preparedness in response to disasters".  Public Complacency Under Repeated Emergency Threats, Xiaohu Wang, Naim Kapucu

• "... the government's internal preparation and use of communication tools had an impact on the level of the information the public exposed to, while reduced complacency or public reaction to the crisis had an impact on the overall perceived public preparedness.  Managing Public's Complacency and Public Preparedness in Response to 2006 Avian Influenza Crisis in TurkeyFebruary 2016, Naim Kapucu, C. Sitki, Vener Garayev

Individual levels

There are many people working in high-risk situations and there has been considerable write-up on how to prevent complacency in such environments.

We can certainly take a leaf from these in our personal fight against complacency

• “…in order to fight complacency, you have to do something active that gets you thinking about the hazards and risks of the task/job”  SafeStart

• “..the only way we can fight complacency is to be constantly vigilant. We need to adopt processes and behaviors that will help our employees to curb complacency, such as Sharing the safety mission, Adding variety, Supporting observation, Correct errors…All of these ways to battle complacency need to be constant.”  Conserve

• “ .. If you are not thinking about what could go wrong every day, all day while you work, you are not completing the task safely. Taking the  time to listen to your internal safety radar will prevent incidents and will keep you safe.” Airswift

• …your mind is indeed your most important safety "device."... So the first thing people need to do is recognize or accept that their mind will wander if they've done the same thing many times before... So working on your safety-related habits helps to compensate for complacency leading to mind, not on task” OHS Online. 

The key takeaway is that to fight complacency

• We have to be first aware of it

• Don’t make it into something routine

• Continue to inculcate good COVID-19 habits like wearing masks, social distancing and hand washing

Summary

• There are signs that we are getting “numb” and complacent with Covid-19

• This is partly due to information overload and partly due to the success in getting the virus under control.

• Both the authorities need to fight this complacency

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.